April 2020 We have seen instances where 15 people have said, ‘This is an amazing idea. “You think about the drugs that now command six-figure prices, [some] don’t come anywhere close to that.”Furthermore, hospital-at-home care has been shown to achieve shorter average lengths of stay compared to traditional in-patient care, at 3.2 days compared to 5.5 days, respectively.

“Several were intrigued,” she notes. De Pirro, an internist who is the one full-time physician with the hospital at home program, says that she and her team of nurse practitioners “act like hospitalists when we’re doing hospital at home, but then follow patients with primary care once they’re discharged.”Marshfield Clinic in Marshfield, Wisc., launched a hospital at home program in 2016—and over the past year, has expanded that program from six conditions to more than 150 DRGs. That study looked at the feasibility and outcomes of a hospital at home programChampioning both hospital at home and home-based primary care, Dr. Leff says he’s convinced that rehab and observation stays—in addition to palliative care—will eventually migrate out of the hospital into patients’ homes. That plan is then carried out through in-home visits by an acute-care nurse along with virtual in-home physician visits, both of which are paired with access to a 24/7 recovery care coordinator.Other keys parts of the company’s model include medication education and the delivery of other medical care at home such as IVs and wound care.Because of reimbursement barriers in fee-for-service Medicare, MA has grown into an area of focus for Contessa, according to Messina.

But there are a number of hurdles that stand in the way of partnership …

“Plus, our length of stay went down 34%.”However, several systems around the country have alternative funding, innovation grants or even their own health plans—and they still run into additional barriers setting up programs.

“The ability to disrupt the system with this model is vast.”Specifically, skilled nursing, oncology care and follow-up care after certain surgical procedures can take place in the home, according to Dr. Leff.But for all that to happen, at-home care providers will need to serve as the “boots on the ground.”Although it has been around for a long time and is more popular in other parts of the world, the hospital-at-home model has not fully caught on in the United States.

In its partnership with Marshfield, for example, Contessa achieved an almost 40% reduction in hospital readmission rates and a 92% enrollment rate, the New England Journal of Medicine previously reported.In addition to Marshfield, Contessa works with CommonSpirit, Mount Sinai and Ascension Saint Thomas. Be the First to Comment! “We’re anxious to learn how to scale this up.

With about 100 employees as of May, Contessa is one of the largest hospital-at-home programs around.Covered by some Medicare Advantage (MA) plans, Contessa’s home recovery model revolves around a doctor-driven care plan. Broadly, hospital-at-home programs attempt to provide acute, hospital-level care in the home in lieu of an expensive, potentially dangerous hospital admission. The early discharge option “is particularly true for wound care or patients who have pneumonias or infections that require long-term antibiotic therapy,” she points out. May 2020 The Hospital at Home Model: Bringing Hospital-Level Care to the Patient 5 Rapid Response The program’s narrow geographic radius helps to ensure physicians and nurses can get to a patient’s home within a half-hour should a patient’s symp-toms worsen.

“I followed them all out through their hospitalizations and only one needed their care escalated to the ICU.” Extrapolating from that review, he estimates that hospital at home in his hospital system could safely handle 2,200 admissions a year, given that his program manages approximately 20,000 patients a year.However, only “health systems of a certain type” will offer hospital at home in the future, says Dr. Leff. “You can make all the clinical arguments you want. HHCN is part of the Aging Media Network.Receive industry updates and breaking news from HHCNReceive industry updates and breaking news from HHCN

To do so, programs try to identify eligible patients whose medical conditions can be cared for in the home setting through coordinated nursing and clinician visits, plus necessary testing and treatment.Although hospital-at-home models aren’t as common in the U.S. as they are abroad, multiple noteworthy programs have emerged over the past 10 years.